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Introduction: Stigma associated with HIV has been documented as a barrier for accessing quality health-related services. When the stigma manifests in the healthcare setting, people living with HIV receive substandard services or even be denied care altogether. Although the consequences of HIV stigma have been documented extensively, efforts to reduce these negative attitudes have been scarce. Interventions to reduce HIV stigma should be implemented as part of the formal training of future healthcare professionals. The interventions that have been tested with healthcare professionals and published have several limitations that must be surpassed (i.e., lack of comparison groups in research designs and longitudinal follow-up data). Furthermore, Latino healthcare professionals have been absent from these intervention efforts even though the epidemic has affected this population disproportionately. Methods: In this article, we describe an intervention developed to reduce HIV stigma among medical students in Puerto Rico. A total of 507 medical students were randomly introduced into our intervention and control conditions. Results: The results show statistically significant differences between the intervention and control groups; intervention group participants had lower HIV stigma levels than control participants after the intervention. In addition, differences in HIV stigma levels between the groups were sustained for a 12-month period. Conclusions: The results of our study demonstrate the efficacy of the modes of intervention developed by us and serve as a new training tool for future healthcare professionals with regard to stigma reduction. Keywords: HIV; stigma; intervention; reduction; Puerto Rico., Introduction The burden of HIV in the Caribbean and Puerto Rico The Caribbean is the second most HIV-affected region in the world with an estimated prevalence of 1% [1]. The [...]

The Community Training Institute for Health Disparities (CTIHD) designed a curriculum for a community health promotion program to provide training and enable community members to facilitate community action by empowering individuals with health education, knowledge, and skills to respond to community health needs, specifically to vulnerable communities in Puerto Rico which had already being affected by natural disasters, the COVID-19 pandemic, and migration. A problem-based curriculum design that integrates a competency-based learning model, which included the creation and development of two courses: Introduction to Community Health Promotion and Community Wellness & Health Promotion. Each course consisted of 10 sessions lasting three hours per session. The assessment per session included a pre- and post-test and overall evaluation of the session, and a discussion or practice exercise at the end of the session. Descriptive statistics (frequencies and percentage) were performed to develop the profile of community participants. Central tendency measures (mean and median), and dispersion measures (variance and standard deviation) were used to describe the scores. Twelve (12) community leaders from different southern municipalities of Puerto Rico were recruited. Of these, nine completed the first course and eight completed the second (75% retention rate for Course 1 and 67% retention rate for Course 2). An 18% (difference of 1.2) increase in knowledge was obtained for Course a and a 16% (difference of 0.85) for Course 2. This curriculum enhances communities’ resources, providing their leaders with the necessary competencies to impact health behavior, promote prevention, and become a health promoter within their communities. [ABSTRACT FROM AUTHOR]

Monkeypox, a zoonotic infection caused by an orthopoxvirus, is endemic in parts of Africa. On August 4, 2022, the U.S. Department of Health and Human Services declared the U.S. monkeypox outbreak, which began on May 17, to be a public health emergency (1,2). After detection of the first U.S. monkeypox case), CDC and health departments implemented enhanced monkeypox case detection and reporting. Among 2,891 cases reported in the United States through July 22 by 43 states, Puerto Rico, and the District of Columbia (DC), CDC received case report forms for 1,195 (41%) cases by July 27. Among these, 99% of cases were among men; among men with available information, 94% reported male-to-male sexual or close intimate contact during the 3 weeks before symptom onset. Among the 88% of cases with available data, 41% were among non-Hispanic White (White) persons, 28% among Hispanic or Latino (Hispanic) persons, and 26% among non-Hispanic Black or African American (Black) persons. Forty-two percent of persons with monkeypox with available data did not report the typical prodrome as their first symptom, and 46% reported one or more genital lesions during their illness; 41% had HIV infection. Data suggest that widespread community transmission of monkeypox has disproportionately affected gay, bisexual, and other men who have sex with men and racial and ethnic minority groups. Compared with historical reports of monkeypox in areas with endemic disease, currently reported outbreak-associated cases are less likely to have a prodrome and more likely to have genital involvement. CDC and other federal, state, and local agencies have implemented response efforts to expand testing, treatment, and vaccination. Public health efforts should prioritize gay, bisexual, and other men who have sex with men, who are currently disproportionately affected, for prevention and testing, while addressing equity, minimizing stigma, and maintaining vigilance for transmission in other populations. Clinicians should test patients with rash consistent with monkeypox, † regardless of whether the rash is disseminated or was preceded by prodrome. Likewise, although most cases to date have occurred among gay, bisexual, and other men who have sex with men, any patient with rash consistent with monkeypox should be considered for testing. CDC is continually evaluating new evidence and tailoring response strategies as information on changing case demographics, clinical characteristics, transmission, and vaccine effectiveness become available. § ., Competing Interests: All authors have completed and submitted the International Committee of Medical Journal Editors form for disclosure of potential conflicts of interest. Mary-Margaret A. Fill reports Council of State and Territorial Epidemiologists (CSTE) travel support to attend annual CSTE conference and uncompensated membership on the University of Tennessee’s One Health Initiative board. No other potential conflicts of interest were disclosed.